Transtibial Osseointegration for Patients with Peripheral Vascular Disease

Background:. The management of peripheral vascular disease (PVD) can require amputation. Osseointegration surgery is an emerging rehabilitation strategy for amputees. In this study, we report on 6 patients who had PVD requiring transtibial amputation (PVD-TTA) and either simultaneous or subsequent osseointegration (PVD-TTOI). Methods:. Six patients (aged 36 to 84 years) with transtibial amputation and preexisting PVD underwent osseointegration between 2014 and 2016 and were followed for 3 to 5 years. Pre- and postoperative clinical and functional outcomes (pain, prosthesis wear time, mobility, walking ability, and quality of life) and adverse events (infection, fracture, implant failure, revision surgery, additional amputation, and death) were prospectively recorded. Results:. All patients’ mobility improved following osseointegration. Three patients initially had required the use of a wheelchair, precluding baseline walking tests; the other 3 were classified as K level 1 or 2, with mean baseline Timed Up and Go (TUG) test = 14.0 ± 2.2 s and 6-Minute Walk Test (6MWT) = 262 ± 75 m. At the time of the latest follow-up, all patients were K level 2 or 3; mean TUG = 12.7 ± 7.2 s and 6MWT = 353 ± 148 m. Four patients wore their prosthesis ≥16 hours daily. Three patients had superficial soft-tissue infections. One other patient experienced recurrent infections 2.8 years after osseointegration requiring debridements and transfemoral amputation; the patient died 2 days following surgery from myocardial infarction caused by coronary atherosclerosis. Conclusions:. All 6 patients who underwent PVD-TTOI in this case series survived through 2 years. Patients who initially had used a wheelchair achieved and maintained independent, unaided ambulation until PVD-related impairments in the contralateral leg occurred in 1 patient. Patients previously using a traditional socket prosthesis reported improvement in mobility and quality of life. One patient’s death underscores the importance of careful patient selection. However, marked improvement in the other 5 patients suggests cautious optimism that PVD-TTA is not an absolute osseointegration contraindication. Conscientious further investigation seems appropriate. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Muhammad Adeel Akhtar, BSc, MBBS, MRCSEd, Dip SEM(UK), MD(Res), MFSEM, MFSTEd, PGDipCAOS, FEBOT, FRCSEd(T&O) [verfasserIn] Jason Shih Hoellwarth, MD [verfasserIn] Shakib Al-Jawazneh, MD [verfasserIn] William Lu, PhD [verfasserIn] Claudia Roberts, BPhysio(Hons) [verfasserIn] Munjed Al Muderis, MB, ChB, FRACS, FAOrthA [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Übergeordnetes Werk:	In: JBJS Open Access - Wolters Kluwer, 2017, 6(2021), 2
Übergeordnetes Werk:	volume:6 ; year:2021 ; number:2

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.2106/JBJS.OA.20.00113

Katalog-ID:	DOAJ001030698

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allfields	10.2106/JBJS.OA.20.00113 doi (DE-627)DOAJ001030698 (DE-599)DOAJ0feb8fc0af8b4019846a008be48f3a52 DE-627 ger DE-627 rakwb eng RD701-811 Muhammad Adeel Akhtar, BSc, MBBS, MRCSEd, Dip SEM(UK), MD(Res), MFSEM, MFSTEd, PGDipCAOS, FEBOT, FRCSEd(T&O) verfasserin aut Transtibial Osseointegration for Patients with Peripheral Vascular Disease 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background:. The management of peripheral vascular disease (PVD) can require amputation. Osseointegration surgery is an emerging rehabilitation strategy for amputees. In this study, we report on 6 patients who had PVD requiring transtibial amputation (PVD-TTA) and either simultaneous or subsequent osseointegration (PVD-TTOI). Methods:. Six patients (aged 36 to 84 years) with transtibial amputation and preexisting PVD underwent osseointegration between 2014 and 2016 and were followed for 3 to 5 years. Pre- and postoperative clinical and functional outcomes (pain, prosthesis wear time, mobility, walking ability, and quality of life) and adverse events (infection, fracture, implant failure, revision surgery, additional amputation, and death) were prospectively recorded. Results:. All patients’ mobility improved following osseointegration. Three patients initially had required the use of a wheelchair, precluding baseline walking tests; the other 3 were classified as K level 1 or 2, with mean baseline Timed Up and Go (TUG) test = 14.0 ± 2.2 s and 6-Minute Walk Test (6MWT) = 262 ± 75 m. At the time of the latest follow-up, all patients were K level 2 or 3; mean TUG = 12.7 ± 7.2 s and 6MWT = 353 ± 148 m. Four patients wore their prosthesis ≥16 hours daily. Three patients had superficial soft-tissue infections. One other patient experienced recurrent infections 2.8 years after osseointegration requiring debridements and transfemoral amputation; the patient died 2 days following surgery from myocardial infarction caused by coronary atherosclerosis. Conclusions:. All 6 patients who underwent PVD-TTOI in this case series survived through 2 years. Patients who initially had used a wheelchair achieved and maintained independent, unaided ambulation until PVD-related impairments in the contralateral leg occurred in 1 patient. Patients previously using a traditional socket prosthesis reported improvement in mobility and quality of life. One patient’s death underscores the importance of careful patient selection. However, marked improvement in the other 5 patients suggests cautious optimism that PVD-TTA is not an absolute osseointegration contraindication. Conscientious further investigation seems appropriate. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Orthopedic surgery Jason Shih Hoellwarth, MD verfasserin aut Shakib Al-Jawazneh, MD verfasserin aut William Lu, PhD verfasserin aut Claudia Roberts, BPhysio(Hons) verfasserin aut Munjed Al Muderis, MB, ChB, FRACS, FAOrthA verfasserin aut In JBJS Open Access Wolters Kluwer, 2017 6(2021), 2 (DE-627)87213704X (DE-600)2873843-3 24727245 nnns volume:6 year:2021 number:2 https://doi.org/10.2106/JBJS.OA.20.00113 kostenfrei https://doaj.org/article/0feb8fc0af8b4019846a008be48f3a52 kostenfrei http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.20.00113 kostenfrei https://doaj.org/toc/2472-7245 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2021 2
spelling	10.2106/JBJS.OA.20.00113 doi (DE-627)DOAJ001030698 (DE-599)DOAJ0feb8fc0af8b4019846a008be48f3a52 DE-627 ger DE-627 rakwb eng RD701-811 Muhammad Adeel Akhtar, BSc, MBBS, MRCSEd, Dip SEM(UK), MD(Res), MFSEM, MFSTEd, PGDipCAOS, FEBOT, FRCSEd(T&O) verfasserin aut Transtibial Osseointegration for Patients with Peripheral Vascular Disease 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background:. The management of peripheral vascular disease (PVD) can require amputation. Osseointegration surgery is an emerging rehabilitation strategy for amputees. In this study, we report on 6 patients who had PVD requiring transtibial amputation (PVD-TTA) and either simultaneous or subsequent osseointegration (PVD-TTOI). Methods:. Six patients (aged 36 to 84 years) with transtibial amputation and preexisting PVD underwent osseointegration between 2014 and 2016 and were followed for 3 to 5 years. Pre- and postoperative clinical and functional outcomes (pain, prosthesis wear time, mobility, walking ability, and quality of life) and adverse events (infection, fracture, implant failure, revision surgery, additional amputation, and death) were prospectively recorded. Results:. All patients’ mobility improved following osseointegration. Three patients initially had required the use of a wheelchair, precluding baseline walking tests; the other 3 were classified as K level 1 or 2, with mean baseline Timed Up and Go (TUG) test = 14.0 ± 2.2 s and 6-Minute Walk Test (6MWT) = 262 ± 75 m. At the time of the latest follow-up, all patients were K level 2 or 3; mean TUG = 12.7 ± 7.2 s and 6MWT = 353 ± 148 m. Four patients wore their prosthesis ≥16 hours daily. Three patients had superficial soft-tissue infections. One other patient experienced recurrent infections 2.8 years after osseointegration requiring debridements and transfemoral amputation; the patient died 2 days following surgery from myocardial infarction caused by coronary atherosclerosis. Conclusions:. All 6 patients who underwent PVD-TTOI in this case series survived through 2 years. Patients who initially had used a wheelchair achieved and maintained independent, unaided ambulation until PVD-related impairments in the contralateral leg occurred in 1 patient. Patients previously using a traditional socket prosthesis reported improvement in mobility and quality of life. One patient’s death underscores the importance of careful patient selection. However, marked improvement in the other 5 patients suggests cautious optimism that PVD-TTA is not an absolute osseointegration contraindication. Conscientious further investigation seems appropriate. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Orthopedic surgery Jason Shih Hoellwarth, MD verfasserin aut Shakib Al-Jawazneh, MD verfasserin aut William Lu, PhD verfasserin aut Claudia Roberts, BPhysio(Hons) verfasserin aut Munjed Al Muderis, MB, ChB, FRACS, FAOrthA verfasserin aut In JBJS Open Access Wolters Kluwer, 2017 6(2021), 2 (DE-627)87213704X (DE-600)2873843-3 24727245 nnns volume:6 year:2021 number:2 https://doi.org/10.2106/JBJS.OA.20.00113 kostenfrei https://doaj.org/article/0feb8fc0af8b4019846a008be48f3a52 kostenfrei http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.20.00113 kostenfrei https://doaj.org/toc/2472-7245 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2021 2
allfields_unstemmed	10.2106/JBJS.OA.20.00113 doi (DE-627)DOAJ001030698 (DE-599)DOAJ0feb8fc0af8b4019846a008be48f3a52 DE-627 ger DE-627 rakwb eng RD701-811 Muhammad Adeel Akhtar, BSc, MBBS, MRCSEd, Dip SEM(UK), MD(Res), MFSEM, MFSTEd, PGDipCAOS, FEBOT, FRCSEd(T&O) verfasserin aut Transtibial Osseointegration for Patients with Peripheral Vascular Disease 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background:. The management of peripheral vascular disease (PVD) can require amputation. Osseointegration surgery is an emerging rehabilitation strategy for amputees. In this study, we report on 6 patients who had PVD requiring transtibial amputation (PVD-TTA) and either simultaneous or subsequent osseointegration (PVD-TTOI). Methods:. Six patients (aged 36 to 84 years) with transtibial amputation and preexisting PVD underwent osseointegration between 2014 and 2016 and were followed for 3 to 5 years. Pre- and postoperative clinical and functional outcomes (pain, prosthesis wear time, mobility, walking ability, and quality of life) and adverse events (infection, fracture, implant failure, revision surgery, additional amputation, and death) were prospectively recorded. Results:. All patients’ mobility improved following osseointegration. Three patients initially had required the use of a wheelchair, precluding baseline walking tests; the other 3 were classified as K level 1 or 2, with mean baseline Timed Up and Go (TUG) test = 14.0 ± 2.2 s and 6-Minute Walk Test (6MWT) = 262 ± 75 m. At the time of the latest follow-up, all patients were K level 2 or 3; mean TUG = 12.7 ± 7.2 s and 6MWT = 353 ± 148 m. Four patients wore their prosthesis ≥16 hours daily. Three patients had superficial soft-tissue infections. One other patient experienced recurrent infections 2.8 years after osseointegration requiring debridements and transfemoral amputation; the patient died 2 days following surgery from myocardial infarction caused by coronary atherosclerosis. Conclusions:. All 6 patients who underwent PVD-TTOI in this case series survived through 2 years. Patients who initially had used a wheelchair achieved and maintained independent, unaided ambulation until PVD-related impairments in the contralateral leg occurred in 1 patient. Patients previously using a traditional socket prosthesis reported improvement in mobility and quality of life. One patient’s death underscores the importance of careful patient selection. However, marked improvement in the other 5 patients suggests cautious optimism that PVD-TTA is not an absolute osseointegration contraindication. Conscientious further investigation seems appropriate. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Orthopedic surgery Jason Shih Hoellwarth, MD verfasserin aut Shakib Al-Jawazneh, MD verfasserin aut William Lu, PhD verfasserin aut Claudia Roberts, BPhysio(Hons) verfasserin aut Munjed Al Muderis, MB, ChB, FRACS, FAOrthA verfasserin aut In JBJS Open Access Wolters Kluwer, 2017 6(2021), 2 (DE-627)87213704X (DE-600)2873843-3 24727245 nnns volume:6 year:2021 number:2 https://doi.org/10.2106/JBJS.OA.20.00113 kostenfrei https://doaj.org/article/0feb8fc0af8b4019846a008be48f3a52 kostenfrei http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.20.00113 kostenfrei https://doaj.org/toc/2472-7245 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2021 2
allfieldsGer	10.2106/JBJS.OA.20.00113 doi (DE-627)DOAJ001030698 (DE-599)DOAJ0feb8fc0af8b4019846a008be48f3a52 DE-627 ger DE-627 rakwb eng RD701-811 Muhammad Adeel Akhtar, BSc, MBBS, MRCSEd, Dip SEM(UK), MD(Res), MFSEM, MFSTEd, PGDipCAOS, FEBOT, FRCSEd(T&O) verfasserin aut Transtibial Osseointegration for Patients with Peripheral Vascular Disease 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background:. The management of peripheral vascular disease (PVD) can require amputation. Osseointegration surgery is an emerging rehabilitation strategy for amputees. In this study, we report on 6 patients who had PVD requiring transtibial amputation (PVD-TTA) and either simultaneous or subsequent osseointegration (PVD-TTOI). Methods:. Six patients (aged 36 to 84 years) with transtibial amputation and preexisting PVD underwent osseointegration between 2014 and 2016 and were followed for 3 to 5 years. Pre- and postoperative clinical and functional outcomes (pain, prosthesis wear time, mobility, walking ability, and quality of life) and adverse events (infection, fracture, implant failure, revision surgery, additional amputation, and death) were prospectively recorded. Results:. All patients’ mobility improved following osseointegration. Three patients initially had required the use of a wheelchair, precluding baseline walking tests; the other 3 were classified as K level 1 or 2, with mean baseline Timed Up and Go (TUG) test = 14.0 ± 2.2 s and 6-Minute Walk Test (6MWT) = 262 ± 75 m. At the time of the latest follow-up, all patients were K level 2 or 3; mean TUG = 12.7 ± 7.2 s and 6MWT = 353 ± 148 m. Four patients wore their prosthesis ≥16 hours daily. Three patients had superficial soft-tissue infections. One other patient experienced recurrent infections 2.8 years after osseointegration requiring debridements and transfemoral amputation; the patient died 2 days following surgery from myocardial infarction caused by coronary atherosclerosis. Conclusions:. All 6 patients who underwent PVD-TTOI in this case series survived through 2 years. Patients who initially had used a wheelchair achieved and maintained independent, unaided ambulation until PVD-related impairments in the contralateral leg occurred in 1 patient. Patients previously using a traditional socket prosthesis reported improvement in mobility and quality of life. One patient’s death underscores the importance of careful patient selection. However, marked improvement in the other 5 patients suggests cautious optimism that PVD-TTA is not an absolute osseointegration contraindication. Conscientious further investigation seems appropriate. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Orthopedic surgery Jason Shih Hoellwarth, MD verfasserin aut Shakib Al-Jawazneh, MD verfasserin aut William Lu, PhD verfasserin aut Claudia Roberts, BPhysio(Hons) verfasserin aut Munjed Al Muderis, MB, ChB, FRACS, FAOrthA verfasserin aut In JBJS Open Access Wolters Kluwer, 2017 6(2021), 2 (DE-627)87213704X (DE-600)2873843-3 24727245 nnns volume:6 year:2021 number:2 https://doi.org/10.2106/JBJS.OA.20.00113 kostenfrei https://doaj.org/article/0feb8fc0af8b4019846a008be48f3a52 kostenfrei http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.20.00113 kostenfrei https://doaj.org/toc/2472-7245 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2021 2
allfieldsSound	10.2106/JBJS.OA.20.00113 doi (DE-627)DOAJ001030698 (DE-599)DOAJ0feb8fc0af8b4019846a008be48f3a52 DE-627 ger DE-627 rakwb eng RD701-811 Muhammad Adeel Akhtar, BSc, MBBS, MRCSEd, Dip SEM(UK), MD(Res), MFSEM, MFSTEd, PGDipCAOS, FEBOT, FRCSEd(T&O) verfasserin aut Transtibial Osseointegration for Patients with Peripheral Vascular Disease 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background:. The management of peripheral vascular disease (PVD) can require amputation. Osseointegration surgery is an emerging rehabilitation strategy for amputees. In this study, we report on 6 patients who had PVD requiring transtibial amputation (PVD-TTA) and either simultaneous or subsequent osseointegration (PVD-TTOI). Methods:. Six patients (aged 36 to 84 years) with transtibial amputation and preexisting PVD underwent osseointegration between 2014 and 2016 and were followed for 3 to 5 years. Pre- and postoperative clinical and functional outcomes (pain, prosthesis wear time, mobility, walking ability, and quality of life) and adverse events (infection, fracture, implant failure, revision surgery, additional amputation, and death) were prospectively recorded. Results:. All patients’ mobility improved following osseointegration. Three patients initially had required the use of a wheelchair, precluding baseline walking tests; the other 3 were classified as K level 1 or 2, with mean baseline Timed Up and Go (TUG) test = 14.0 ± 2.2 s and 6-Minute Walk Test (6MWT) = 262 ± 75 m. At the time of the latest follow-up, all patients were K level 2 or 3; mean TUG = 12.7 ± 7.2 s and 6MWT = 353 ± 148 m. Four patients wore their prosthesis ≥16 hours daily. Three patients had superficial soft-tissue infections. One other patient experienced recurrent infections 2.8 years after osseointegration requiring debridements and transfemoral amputation; the patient died 2 days following surgery from myocardial infarction caused by coronary atherosclerosis. Conclusions:. All 6 patients who underwent PVD-TTOI in this case series survived through 2 years. Patients who initially had used a wheelchair achieved and maintained independent, unaided ambulation until PVD-related impairments in the contralateral leg occurred in 1 patient. Patients previously using a traditional socket prosthesis reported improvement in mobility and quality of life. One patient’s death underscores the importance of careful patient selection. However, marked improvement in the other 5 patients suggests cautious optimism that PVD-TTA is not an absolute osseointegration contraindication. Conscientious further investigation seems appropriate. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Orthopedic surgery Jason Shih Hoellwarth, MD verfasserin aut Shakib Al-Jawazneh, MD verfasserin aut William Lu, PhD verfasserin aut Claudia Roberts, BPhysio(Hons) verfasserin aut Munjed Al Muderis, MB, ChB, FRACS, FAOrthA verfasserin aut In JBJS Open Access Wolters Kluwer, 2017 6(2021), 2 (DE-627)87213704X (DE-600)2873843-3 24727245 nnns volume:6 year:2021 number:2 https://doi.org/10.2106/JBJS.OA.20.00113 kostenfrei https://doaj.org/article/0feb8fc0af8b4019846a008be48f3a52 kostenfrei http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.20.00113 kostenfrei https://doaj.org/toc/2472-7245 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2021 2
language	English
source	In JBJS Open Access 6(2021), 2 volume:6 year:2021 number:2
sourceStr	In JBJS Open Access 6(2021), 2 volume:6 year:2021 number:2
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Orthopedic surgery
isfreeaccess_bool	true
container_title	JBJS Open Access
authorswithroles_txt_mv	Muhammad Adeel Akhtar, BSc, MBBS, MRCSEd, Dip SEM(UK), MD(Res), MFSEM, MFSTEd, PGDipCAOS, FEBOT, FRCSEd(T&O) @@aut@@ Jason Shih Hoellwarth, MD @@aut@@ Shakib Al-Jawazneh, MD @@aut@@ William Lu, PhD @@aut@@ Claudia Roberts, BPhysio(Hons) @@aut@@ Munjed Al Muderis, MB, ChB, FRACS, FAOrthA @@aut@@
publishDateDaySort_date	2021-01-01T00:00:00Z
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The management of peripheral vascular disease (PVD) can require amputation. Osseointegration surgery is an emerging rehabilitation strategy for amputees. In this study, we report on 6 patients who had PVD requiring transtibial amputation (PVD-TTA) and either simultaneous or subsequent osseointegration (PVD-TTOI). Methods:. Six patients (aged 36 to 84 years) with transtibial amputation and preexisting PVD underwent osseointegration between 2014 and 2016 and were followed for 3 to 5 years. Pre- and postoperative clinical and functional outcomes (pain, prosthesis wear time, mobility, walking ability, and quality of life) and adverse events (infection, fracture, implant failure, revision surgery, additional amputation, and death) were prospectively recorded. Results:. All patients’ mobility improved following osseointegration. Three patients initially had required the use of a wheelchair, precluding baseline walking tests; the other 3 were classified as K level 1 or 2, with mean baseline Timed Up and Go (TUG) test = 14.0 ± 2.2 s and 6-Minute Walk Test (6MWT) = 262 ± 75 m. At the time of the latest follow-up, all patients were K level 2 or 3; mean TUG = 12.7 ± 7.2 s and 6MWT = 353 ± 148 m. Four patients wore their prosthesis ≥16 hours daily. Three patients had superficial soft-tissue infections. One other patient experienced recurrent infections 2.8 years after osseointegration requiring debridements and transfemoral amputation; the patient died 2 days following surgery from myocardial infarction caused by coronary atherosclerosis. Conclusions:. All 6 patients who underwent PVD-TTOI in this case series survived through 2 years. Patients who initially had used a wheelchair achieved and maintained independent, unaided ambulation until PVD-related impairments in the contralateral leg occurred in 1 patient. 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callnumber-first	R - Medicine
author	Muhammad Adeel Akhtar, BSc, MBBS, MRCSEd, Dip SEM(UK), MD(Res), MFSEM, MFSTEd, PGDipCAOS, FEBOT, FRCSEd(T&O)
spellingShingle	Muhammad Adeel Akhtar, BSc, MBBS, MRCSEd, Dip SEM(UK), MD(Res), MFSEM, MFSTEd, PGDipCAOS, FEBOT, FRCSEd(T&O) misc RD701-811 misc Orthopedic surgery Transtibial Osseointegration for Patients with Peripheral Vascular Disease
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topic_title	RD701-811 Transtibial Osseointegration for Patients with Peripheral Vascular Disease
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title	Transtibial Osseointegration for Patients with Peripheral Vascular Disease
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title_full	Transtibial Osseointegration for Patients with Peripheral Vascular Disease
author_sort	Muhammad Adeel Akhtar, BSc, MBBS, MRCSEd, Dip SEM(UK), MD(Res), MFSEM, MFSTEd, PGDipCAOS, FEBOT, FRCSEd(T&O)
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author_browse	Muhammad Adeel Akhtar, BSc, MBBS, MRCSEd, Dip SEM(UK), MD(Res), MFSEM, MFSTEd, PGDipCAOS, FEBOT, FRCSEd(T&O) Jason Shih Hoellwarth, MD Shakib Al-Jawazneh, MD William Lu, PhD Claudia Roberts, BPhysio(Hons) Munjed Al Muderis, MB, ChB, FRACS, FAOrthA
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author-letter	Muhammad Adeel Akhtar, BSc, MBBS, MRCSEd, Dip SEM(UK), MD(Res), MFSEM, MFSTEd, PGDipCAOS, FEBOT, FRCSEd(T&O)
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title_sort	transtibial osseointegration for patients with peripheral vascular disease
callnumber	RD701-811
title_auth	Transtibial Osseointegration for Patients with Peripheral Vascular Disease
abstract	Background:. The management of peripheral vascular disease (PVD) can require amputation. Osseointegration surgery is an emerging rehabilitation strategy for amputees. In this study, we report on 6 patients who had PVD requiring transtibial amputation (PVD-TTA) and either simultaneous or subsequent osseointegration (PVD-TTOI). Methods:. Six patients (aged 36 to 84 years) with transtibial amputation and preexisting PVD underwent osseointegration between 2014 and 2016 and were followed for 3 to 5 years. Pre- and postoperative clinical and functional outcomes (pain, prosthesis wear time, mobility, walking ability, and quality of life) and adverse events (infection, fracture, implant failure, revision surgery, additional amputation, and death) were prospectively recorded. Results:. All patients’ mobility improved following osseointegration. Three patients initially had required the use of a wheelchair, precluding baseline walking tests; the other 3 were classified as K level 1 or 2, with mean baseline Timed Up and Go (TUG) test = 14.0 ± 2.2 s and 6-Minute Walk Test (6MWT) = 262 ± 75 m. At the time of the latest follow-up, all patients were K level 2 or 3; mean TUG = 12.7 ± 7.2 s and 6MWT = 353 ± 148 m. Four patients wore their prosthesis ≥16 hours daily. Three patients had superficial soft-tissue infections. One other patient experienced recurrent infections 2.8 years after osseointegration requiring debridements and transfemoral amputation; the patient died 2 days following surgery from myocardial infarction caused by coronary atherosclerosis. Conclusions:. All 6 patients who underwent PVD-TTOI in this case series survived through 2 years. Patients who initially had used a wheelchair achieved and maintained independent, unaided ambulation until PVD-related impairments in the contralateral leg occurred in 1 patient. Patients previously using a traditional socket prosthesis reported improvement in mobility and quality of life. One patient’s death underscores the importance of careful patient selection. However, marked improvement in the other 5 patients suggests cautious optimism that PVD-TTA is not an absolute osseointegration contraindication. Conscientious further investigation seems appropriate. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
abstractGer	Background:. The management of peripheral vascular disease (PVD) can require amputation. Osseointegration surgery is an emerging rehabilitation strategy for amputees. In this study, we report on 6 patients who had PVD requiring transtibial amputation (PVD-TTA) and either simultaneous or subsequent osseointegration (PVD-TTOI). Methods:. Six patients (aged 36 to 84 years) with transtibial amputation and preexisting PVD underwent osseointegration between 2014 and 2016 and were followed for 3 to 5 years. Pre- and postoperative clinical and functional outcomes (pain, prosthesis wear time, mobility, walking ability, and quality of life) and adverse events (infection, fracture, implant failure, revision surgery, additional amputation, and death) were prospectively recorded. Results:. All patients’ mobility improved following osseointegration. Three patients initially had required the use of a wheelchair, precluding baseline walking tests; the other 3 were classified as K level 1 or 2, with mean baseline Timed Up and Go (TUG) test = 14.0 ± 2.2 s and 6-Minute Walk Test (6MWT) = 262 ± 75 m. At the time of the latest follow-up, all patients were K level 2 or 3; mean TUG = 12.7 ± 7.2 s and 6MWT = 353 ± 148 m. Four patients wore their prosthesis ≥16 hours daily. Three patients had superficial soft-tissue infections. One other patient experienced recurrent infections 2.8 years after osseointegration requiring debridements and transfemoral amputation; the patient died 2 days following surgery from myocardial infarction caused by coronary atherosclerosis. Conclusions:. All 6 patients who underwent PVD-TTOI in this case series survived through 2 years. Patients who initially had used a wheelchair achieved and maintained independent, unaided ambulation until PVD-related impairments in the contralateral leg occurred in 1 patient. Patients previously using a traditional socket prosthesis reported improvement in mobility and quality of life. One patient’s death underscores the importance of careful patient selection. However, marked improvement in the other 5 patients suggests cautious optimism that PVD-TTA is not an absolute osseointegration contraindication. Conscientious further investigation seems appropriate. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
abstract_unstemmed	Background:. The management of peripheral vascular disease (PVD) can require amputation. Osseointegration surgery is an emerging rehabilitation strategy for amputees. In this study, we report on 6 patients who had PVD requiring transtibial amputation (PVD-TTA) and either simultaneous or subsequent osseointegration (PVD-TTOI). Methods:. Six patients (aged 36 to 84 years) with transtibial amputation and preexisting PVD underwent osseointegration between 2014 and 2016 and were followed for 3 to 5 years. Pre- and postoperative clinical and functional outcomes (pain, prosthesis wear time, mobility, walking ability, and quality of life) and adverse events (infection, fracture, implant failure, revision surgery, additional amputation, and death) were prospectively recorded. Results:. All patients’ mobility improved following osseointegration. Three patients initially had required the use of a wheelchair, precluding baseline walking tests; the other 3 were classified as K level 1 or 2, with mean baseline Timed Up and Go (TUG) test = 14.0 ± 2.2 s and 6-Minute Walk Test (6MWT) = 262 ± 75 m. At the time of the latest follow-up, all patients were K level 2 or 3; mean TUG = 12.7 ± 7.2 s and 6MWT = 353 ± 148 m. Four patients wore their prosthesis ≥16 hours daily. Three patients had superficial soft-tissue infections. One other patient experienced recurrent infections 2.8 years after osseointegration requiring debridements and transfemoral amputation; the patient died 2 days following surgery from myocardial infarction caused by coronary atherosclerosis. Conclusions:. All 6 patients who underwent PVD-TTOI in this case series survived through 2 years. Patients who initially had used a wheelchair achieved and maintained independent, unaided ambulation until PVD-related impairments in the contralateral leg occurred in 1 patient. Patients previously using a traditional socket prosthesis reported improvement in mobility and quality of life. One patient’s death underscores the importance of careful patient selection. However, marked improvement in the other 5 patients suggests cautious optimism that PVD-TTA is not an absolute osseointegration contraindication. Conscientious further investigation seems appropriate. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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title_short	Transtibial Osseointegration for Patients with Peripheral Vascular Disease
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